title: The role of 11C-choline PET imaging in the early detection of recurrence in surgically treated prostate cancer patients with very low PSA level <0.5 ng/mL.
abstract: OBJECTIVE
  This study aims to evaluate the role of (11)C-choline PET/CT in patients with biochemical relapse after radical prostatectomy (RP) showing prostate-specific antigen (PSA) values lower than 0.5 ng/mL.
  
  
  METHODS
  We performed (11)C-choline PET/CT in 71 consecutive patients previously treated with RP showing PSA values lower than 0.5 ng/mL. (11)C-Choline PET/CT was performed following standard procedure. (11)C-Choline PET/CT-positive findings were validated by transrectal ultrasonography + biopsy, repeated (11)C-choline PET/CT, other conventional imaging modality, and histology.
  
  
  RESULTS
  (11)C-Choline PET/CT was true positive in 15/71 (21.1%). (11)C-Choline uptake was observed in pelvic lymph nodes (7/71; 9.9%), in the prostatic bed (7/71; 9.9%), and in bone (1/71; 1.4%). Mean PSA, PSA doubling time (PSAdt), and PSA velocity (PSAvel) values ± SD in (11)C-choline PET/CT-positive patients was 0.37 ± 0.1 ng/mL, 3.4 ± 2.1 months, and 0.05 ± 0.1 ng/mL/yr, respectively. (11)C-Choline PET/CT was false negative in 2 patients and false positive in 1 patient. Among all variables, only PSAdt and the ongoing hormonal treatment were statistically significant in the prediction of a positive (11)C-choline PET/CT at multivariate analysis.
  
  
  CONCLUSIONS
  (11)C-Choline PET/CT could be used early after biochemical failure even if PSA values are very low, preferentially in hormonal resistant patients showing fast PSA kinetics. An early detection of the site of relapse could lead to a personalized and tailored treatment.
authors.affiliation: Department of Nuclear Medicine, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Mamede
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceci
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellucci
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Chiara
authors.initials: C
authors.lastname: Fuccio
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Eugenio
authors.initials: E
authors.lastname: Brunocilla
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fantini
authors.forename: Stefano
authors.initials: S
authors.lastname: Costa
authors.forename: Alice
authors.initials: A
authors.lastname: Ferretti
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Colletti
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D002250:Carbon Radioisotopes; D002794:Choline; D055088:Early Detection of Cancer; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery; D049268:Positron-Emission Tomography; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D017430:Prostate-Specific Antigen; D002794:Choline